Foti Caterina, Filotico Raffaele, Calvario Agata, Conserva Anna, Antelmi Annarita, Angelini Giovanni
Department of Internal Medicine, Immunology and Infectious Diseases, Unit of Dermatology, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Eur J Dermatol. 2004 Nov-Dec;14(6):421-3.
We describe the case of a 52-year-old immunocompetent man with recurrent folliculitis on the left cheek, associated with intense pain. Bacteriological, mycological and Tzanck tests from the lesions were negative. Histopathological study showed an aspecific flogosis pattern. Virological tests carried out on swabs and paraffin-embedded tissue sections from the facial lesions by nested PCR technique (nPCR) demonstrated the presence of herpes simplex virus type 2 (HSV\2) in both samples. Skin swabs from other healthy areas of the face resulted negative for herpetic infection. A diagnosis of recurrent herpetic folliculitis by HSV\2 was made. This case report underlines that even in immunocompetent patients HSV\2 lesions can feature atypical clinical aspects. In dermatological assessment the benefits of routine PCR techniques for differential diagnosis of herpetic infection should be considered above all for the prompt initiation of antiviral therapy and appropriate patient management.
我们描述了一名52岁免疫功能正常男性的病例，其左侧脸颊反复出现毛囊炎，并伴有剧烈疼痛。对病变进行的细菌学、真菌学和Tzanck检查均为阴性。组织病理学研究显示为非特异性炎症模式。通过巢式PCR技术（nPCR）对面部病变的拭子和石蜡包埋组织切片进行的病毒学检测表明，两个样本中均存在2型单纯疱疹病毒（HSV-2）。面部其他健康部位的皮肤拭子疱疹感染检测结果为阴性。诊断为HSV-2引起的复发性疱疹性毛囊炎。该病例报告强调，即使在免疫功能正常的患者中，HSV-2病变也可能具有非典型的临床特征。在皮肤病学评估中，常规PCR技术在疱疹感染鉴别诊断中的益处应首先予以考虑，以便及时启动抗病毒治疗并进行适当的患者管理。
